| North Idaho Dental Group | |
|
2165 N. Merritt Creek Loop Coeur D Alene ID 83814 | |
| (208) 667-8282 | |
| (208) 667-9557 |
| Full Name | North Idaho Dental Group |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 2165 N. Merritt Creek Loop, Coeur D Alene, Idaho |
| Authorized Official Name and Position | Benjamin L Gates (DENTIST/OWNER) |
| Authorized Official Contact | 2086917408 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Idaho Dental Group 2165 N. Merritt Creek Loop Coeur D Alene ID 83814 Ph: (208) 667-8282 | North Idaho Dental Group 2165 N. Merritt Creek Loop Coeur D Alene ID 83814 Ph: (208) 667-8282 |
| NPI Number | 1710364427 |
|---|---|
| Provider Enumeration Date | 05/01/2015 |
| Last Update Date | 08/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710364427 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | D3355 (Idaho) | Primary |
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